CClover Health provides Medicare Advantage plans for seniors in the United States, offering coverage that goes beyond traditional Medicare. Its services include personalized care, fitness memberships, home checkups, drug coverage, and Medigap insurance, with revenue coming from member premiums and Medicare reimbursements. The product works by enrolling members in Medicare Advantage and delivering added benefits through a network of healthcare providers and fitness centers, plus home visits and proactive support to manage health. The company differentiates itself with a focus on tailored, attentive care and a growing provider network to enhance member benefits, aiming to improve health outcomes. Its primary goal is to help seniors stay healthier and reduce out-of-pocket costs by combining comprehensive coverage with personalized services.
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Industries
Company Size
501-1,000
Company Stage
IPO
Headquarters
Nashville, Tennessee
Founded
2014
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Clover Health earns top honors in U.S. News & World Report's 2027 Medicare Advantage ratings across three states. Clover Health plans are named Best Medicare Advantage Plans in New Jersey, Georgia, and South Carolina, scoring highest in all three states for Best for Care Continuity. WILMINGTON, Del., Oct. 19, 2026 (GLOBE NEWSWIRE) - Clover Health Investments, Corp. (Nasdaq: CLOV) ("Clover Health" or "Clover"), a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare, today announced that it earned top distinctions across New Jersey, Georgia, and South Carolina in U.S. News & World Report's 2027 Best Insurance Companies for Medicare Advantage ("MA") ratings. The recognition highlights key areas of Clover's approach to MA, including preventive care, continuity of care, and strong physician relationships. "For beneficiaries, having a health plan they can rely on means being able to see the doctors they trust, get preventive care, and know someone is helping connect the dots across their healthcare," said Jamie Reynoso, CEO of Medicare Advantage, Clover Health. "These ratings reflect the work our physicians and local teams do every day, supported by clinical insights from Counterpart Assistant, and reinforce the value of a MA model built around choice, continuity, and putting members first." In the 2027 U.S. News ratings, Clover Health plans were recognized as Best Medicare Advantage Plans in South Carolina, Georgia, and New Jersey, with the following distinctions: * Highest scores in the state of New Jersey for Best Medicare Advantage Plans for Care Continuity; recognized as Best Overall and Best for Screening & Prevention * Highest scores in the state of Georgia for Best Medicare Advantage Plans Overall and Best for Care Continuity; tied as Best for Screening & Prevention * Highest scores in the state of South Carolina in all three categories: Best Medicare Advantage Plans Overall, Best for Screening & Prevention, and Best for Care Continuity Supporting Physicians and More Connected Care This designation follows the announcement of Clover's market-leading performance on core Healthcare Effectiveness Data and Information Set ("HEDIS(R)"[1]) measures with a score of 4.82 out of 5 Stars[2], ranking #1 among non-SNP PPO plans with over 2,000 members for the third year in a row. Clover's wide-network PPO MA model is supported by Counterpart Assistant, its physician-facing technology platform, which provides data-driven clinical insights to help physicians identify care gaps, make informed decisions, and coordinate care. The technology supports physicians' independent clinical judgment and is also offered to external healthcare organizations through Clover's subsidiary, Counterpart Health. The 2027 Annual Enrollment Period runs from October 15 through December 7, 2026. Clover Health plans are available to 5.2 million Medicare-eligible beneficiaries within 203 counties across five states. Plans available based on location are available to view here. About Clover Health: Clover Health (Nasdaq: CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology's impact on Medication Adherence, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and in Underserved Populations as well as the earlier identification and management of Diabetes and Chronic Kidney Disease. Investor Relations: Clover Health is a PPO and HMO organization with a Medicare contract. Enrollment in Clover Health depends on contract renewal. Y0129_26EX091F_C __________________________ [1] HEDIS(R) is a registered trademark of the National Committee for Quality Assurance (NCQA) [2] This analysis focuses on performance by non-SNP PPO plans with over 2,000 lives as of September 1, 2024, 2025, and 2026 on HEDIS measures applicable to non-SNPs that were used for CMS's MY 2023, MY 2024, and MY 2025 Star ratings, applying the measure ranges used by CMS. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
Clover Health Investments reported that nearly half of its Medicare Advantage members joined in 2025 or 2026, a concentration that affects profitability. The company typically earns about $70 more gross profit per member monthly during their second year compared to their first. During the second quarter of fiscal 2026, membership grew 48% year-over-year to an average of 157,000. The 2026 cohort represents approximately 28% of total members, whilst the 2025 cohort accounts for about 21%. Management attributed this growth to disruption in core markets, including New Jersey. Second-quarter gross profit rose 54%, outpacing membership growth, though revenue still increased faster at 56%. The company raised full-year guidance but cautioned it wants to see more claims data before confirming trends will continue.
Astrana Health tells SEC hack exposed sensitive data. Social Engineering Attack Potentially Compromised Patient, Provider, Corporate Data Marianne Kolbasuk McGee (HealthInfoSec) - September 28, 2026 California-based Astrana Health has informed the U.S. Securities and Exchange Commission that a recent hack involving a social engineering campaign against the managed services organization affected a wide variety of sensitive and confidential data that might have been stolen. Astrana in a filing on Wednesday said it recently detected unusual activity in its IT environment. The company didn't disclose the date. "The incident involved a series of social engineering attempts in which threat actors, impersonating company personnel and spoofing the company's main corporate telephone number, contacted certain employees in an effort to obtain unauthorized access to company systems," Astrana told the SEC. Astrana's cybersecurity team responded to the activity, launched an investigation, engaged third-party cybersecurity and digital forensics experts, and notified law enforcement, as well as partners and state and federal regulators, the company said. Astrana said it has also taken remedial actions, including resetting affected credentials, restricting remote access tools, restoring certain systems from clean backups and enhancing monitoring, logging and detection capabilities across its environment. While Astrana's investigation into the hack is ongoing, so far the company said it believes some private and confidential information maintained on its servers was accessed or exfiltrated. Astrana is assessing whether patient, employee, credentialed providers, business and financial information, intellectual property and other information was affected. "While the investigation is ongoing, the company has determined that the incident is material as of Sept. 22, due to the potential confidential and sensitive nature of the data that is involved," Astrana told the SEC. Astrana also said that it still doesn't know the full impact of the incident on "business strategy, operations, financial condition or results of operations, including remediation and response costs, legal, regulatory and notification-related matters, and possible effects on providers, patients, counterparties and the company's reputation, or the impact on the trading price of the company's common stock." But the company said it doesn't expect the hack to affect the company's financial condition or operations. While Astrana said it has cyber insurance that may cover some losses related to the hack, "there can be no assurance that such coverage will be sufficient to cover all losses the company may incur," the filing says. Astrana, which reported total revenue of nearly $3.2 billion in 2025, describes itself on its website as a management services organization comprised of healthcare professionals and more than 600 employee associates. The company provides "comprehensive administrative support and various auxiliary services." As of Friday, no specific threat actor group had yet appeared to claim responsibility on the darkweb for the hack on Astrana. Astrana did not immediately respond to ISMG's request for comment and additional details about the incident. The attack on Astrana is among the latest recent social engineering and phishing hacks reported in recent months to the SEC by large publicly traded healthcare sector companies. Others include an attack reported to the SEC in June by Clover Health, a provider of Medicare Advantage health plans and a vendor of artificial intelligence-enabled clinical decision support tools for physicians. Also, Pennsylvania-based AdaptHealth, a home medical equipment supplier, in July reported a social engineering attack that compromised patient data. AdaptHealth reported the incident to the U.S. Department of Health and Human Services in August as a HIPAA breach affecting more than 4.1 million people (see: Breach Roundup: China Calls for Stronger AI Oversight).
Clover Health adds Torricelli, Miller to board. Former U.S. Sen. Robert Torricelli, D-N.J., and Brian Miller, MD, have been appointed to Clover Health's board of directors, confirming the Clover Health Torricelli Miller board additions announced Sept. 24. What these Clover Health Torricelli Miller board roles will involve. Torricelli will serve on Clover's audit committee, while Miller will be on the clinical committee. This division of committee assignments reflects each new director's distinct background, financial and policy expertise for Torricelli, clinical and Medicare payment policy expertise for Miller. Torricelli's background before this Clover Health board appointment. Torricelli has been a director of Clover's insurance subsidiaries since 2022. He founded business strategy firm Rosemont Associates in 2002 and real estate development firm Woodrose Properties in 2003. He was also executive vice president and COO of healthcare services company Aveta, giving him direct prior healthcare industry operational experience beyond his political and business background. Miller's background behind this Clover Health Torricelli Miller board appointment. Miller is an associate professor at Baltimore-based Johns Hopkins University and has practiced at Johns Hopkins Hospital. Since May 2023, he has been a commissioner on the Medicare Payment Advisory Commission, an agency that advises Congress on Medicare. He has also been on the board of trustees for the North Carolina State Health Plan since January 2025 and became vice chairman in April 2026. Why Miller's federal policy background stands out. Previously, Miller held roles at CMS, the FDA, and federal commissions, giving him direct experience across multiple federal health regulatory and payment bodies. This combination of active MedPAC commissioner status alongside prior CMS and FDA experience positions Miller to bring current, firsthand insight into Medicare payment policy debates directly into Clover's boardroom. Leadership's statement on this Clover Health Torricelli Miller board appointment. "Bob brings deep ties to New Jersey communities, experience navigating federal policy and firsthand knowledge of Clover," Clover CEO Andrew Toy said in the news release. "Brian combines clinical experience with a national perspective on Medicare payment and technology policy. His insights will help us advance care that improves quality, operates more efficiently and generates meaningful savings." Why this combination of directors fits Clover's strategic needs. Toy's framing suggests the two appointments were chosen to complement each other: Torricelli's regional and organizational familiarity with Clover paired with Miller's national Medicare payment and technology policy perspective, potentially strengthening the board's ability to navigate both local market dynamics and evolving federal reimbursement policy simultaneously. How this fits Clover's broader board composition. Clover's board now has nine directors, with the appointments filling two vacancies. This board expansion follows Chelsea Clinton's earlier departure from Clover Health's board, meaning these two new directors are specifically replacing the resulting openings rather than representing a net increase in board size beyond its prior full complement. Why filling these vacancies with this specific expertise matters. Choosing a former senator with existing Clover subsidiary board experience and an active MedPAC commissioner with federal regulatory experience to fill these two vacancies suggests Clover prioritized candidates who could immediately contribute both organizational continuity and current Medicare policy expertise, rather than seeking entirely new outside perspectives. What this Clover Health Torricelli Miller board appointment means going forward. With Miller's active role on MedPAC, the federal commission that advises Congress on Medicare payment policy, Clover Health gains a board member with direct, current insight into the federal policy discussions shaping Medicare Advantage reimbursement, potentially valuable given Clover's business as a Medicare Advantage-focused insurer. Given Torricelli's existing tenure on Clover's insurance subsidiary boards since 2022, his elevation to the parent company board level reflects continuity in governance rather than the introduction of an entirely unfamiliar director. What to watch going forward. As Torricelli and Miller settle into their respective audit and clinical committee roles, industry observers will likely watch whether Miller's MedPAC perspective visibly shapes Clover's approach to Medicare Advantage payment strategy and quality initiatives. Given the broader context of significant executive and board transitions across the payer industry this year, this Clover Health Torricelli Miller board appointment adds to a pattern of insurers seeking directors with direct federal health policy experience as Medicare Advantage reimbursement and regulatory scrutiny continue intensifying industrywide.
Clover Health has appointed former US Senator Robert Torricelli and Dr Brian J. Miller to its board of directors, filling two vacant positions and bringing the board to nine directors. Senator Torricelli will serve on the audit committee, whilst Dr Miller will join the clinical committee. Torricelli represented New Jersey in Congress for 20 years and has served on Clover's insurance subsidiary board since 2022. Dr Miller is a practising hospitalist at Johns Hopkins Hospital and currently serves as a commissioner on the Medicare Payment Advisory Commission. Chief executive Andrew Toy said the appointments strengthen the board with expertise spanning public service, Medicare Advantage, clinical practice and healthcare policy. The company operates a physician enablement technology platform and provides Medicare Advantage plans across several US states.
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Industries
Company Size
501-1,000
Company Stage
IPO
Headquarters
Nashville, Tennessee
Founded
2014
Find jobs on Simplify and start your career today